Social Security Disability (SSD) benefits support those who may no longer be able to work due to a disability. If you plan to seek SSD benefits it is important to know about the reasons your claim could get denied.
Need legal help with your SSD application? Contact our qualified Green Bay Social Security Disability Lawyer today. Even if your claim has already been denied, Sigman Janssen may be able to help you with the appeals process.
We have been helping our clients secure SSD benefits for decades. Our knowledgeable legal team is here to guide you throughout the complicated application process. We charge no upfront fees, and your initial consultation is free with no obligations.
Call us today to schedule your consultation: (920) 335-1394
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1. Incomplete or Insufficient Medical Evidence
A common reason for SSD claims denials is a lack of sufficient medical evidence. Your claim could get denied for incomplete or insufficient medical evidence for these reasons:
Lack of Proof of Disability
The Social Security Administration (SSA) relies heavily on medical documentation to assess the severity of your condition. If your records do not clearly show the diagnosis, treatments and limitations caused by your condition, the SSA may reject your claim.
Inadequate Details
Medical records need to be detailed and specific. Vague or incomplete reports from doctors that do not thoroughly explain your condition, treatment history and how the disability affects your daily life can weaken your claim.
Missing Diagnostic Tests
Medical tests, such as MRI scans, CT scans and blood work, are crucial in proving the existence and severity of your condition. When diagnostic testing is missing, the SSA may not have enough evidence to support your claim.
Gaps in Treatment History
Continuous treatment records help establish that your condition is long-term and requires ongoing medical intervention. Gaps in your treatment history can suggest that your condition may not be as severe as you claimed.
2. Failure to Meet the SSA’s Definition of Disability
The SSA has strict criteria for what is considered a disability. It uses Substantial Gainful Activity (SGA) to describe the level of work activity and earnings that may affect your eligibility for disability benefits.
Your condition must be severe enough to prevent you from working and is expected to last at least 12 months or result in death. Temporary conditions typically do not qualify.
3. Inaccurate or Incomplete Application Forms
An incorrect or incomplete application will result in a denial. The SSD application process involves multiple forms and requires detailed information about your medical history, work background and daily activities.
It is vital that your application is completed and the information is consistent with the medical evidence you provide. Discrepancies between your application and your medical records may result in a denied claim.
You may want to consider having a licensed attorney review your application for errors or missing information before submitting it.
4. Not Following Through with SSA Requests
The SSA may request additional information or documentation during the SSD application process. Failing to respond to these requests within the given period can result in your claim being denied.
It is best to respond promptly to any SSA requests for additional information or documentation. Make sure the information you provide in your response is accurate and complete.
After submitting the additional requests, keep detailed records of all correspondence with the SSA. Keep track of the dates, making sure you meet all deadlines. Timely and accurate responses can prevent unnecessary delays and denials.
5. Prior Denials or Non-qualifying Work History
If you have already been denied SSD benefits, having your claim approved in the future can be more challenging. Before resubmitting your claim, it is vital you understand why previous claims were dismissed and address those issues in your current application.
Your work history is another crucial aspect in determining eligibility for SSD benefits. You must have earned sufficient work credits to qualify. Work credits are based on an applicant’s total yearly wages or self-employment income.
In 2024, you receive one credit for each $1,730 of earnings, up to a maximum of four credits per year. The number of credits you need to qualify for benefits depends on your age when you become disabled. Younger workers may qualify with fewer credits. However, your claim will be denied if you do not meet this requirement.
My Claim Was Denied. What Can I Do Next?
If your SSD claim has been denied, you can take the following steps:
Request a Reconsideration Review
If your initial claim is denied, the first step you can take is to submit a request to have your claim reconsidered. This involves having a different SSA examiner review your case. Requests for reconsideration must filed within 60 days of receiving your denial.
Administrative Law Judge (ALJ) Hearing
If your claim is again denied, the next option for attempting to overturn that decision is to request an ALJ hearing. This review gives you an opportunity to present your case in person.
Appeals Council
If the ALJ denies your claim, there is still another legal option to have the denial overturned. For this stage of the appeal process, you can request a review by the Social Security Appeals Council. They can either decide your case themselves or return it to the ALJ for further review.
Need Help With Your SSD Case After a Denial? Call Sigman Janssen
If you have been denied SSD benefits, it is important to take proactive steps to address the issues and seek legal assistance. At Sigman Janssen, our lawyers have extensive knowledge of SSD benefits claims, and we are prepared to help you.
Call to discuss your situation with one of our qualified attorneys today. Your initial consultation is completely free, and if we represent you, there are no upfront costs or fees.
Call Sigman Janssen for Help With Your SSD Claim: (920) 335-1394.